JP5203757B2 - X-ray equipment - Google Patents

Description

  The present invention relates to an X-ray imaging apparatus that irradiates a subject with X-rays, detects X-rays transmitted through the subject, and generates a fluoroscopic image based on the detected X-rays. The present invention relates to a technique for presenting an appropriate observation direction to an operator.

  Conventionally, in an X-ray angiography examination using an X-ray imaging apparatus such as an X-ray diagnostic apparatus, blood vessels and therapeutic devices (for example, balloons and stents) are observed from various directions under fluoroscopy. Examination and treatment are performed (for example, refer to Patent Document 1). In such an X-ray angiography examination, depending on the observation direction, that is, the X-ray irradiation direction, the organ to be observed and the therapeutic device may overlap with other organs such as bones and may be difficult to see.

  For example, consider the case where a heart vessel is treated using a catheter. FIG. 6 is a diagram illustrating a change in the observation direction in the conventional X-ray imaging apparatus, and FIG. 7 is a diagram illustrating image display in the conventional X-ray imaging apparatus. For example, when the observation direction is set in such a direction that the marker and the bone overlap as shown in FIG. 6A when observing the marker of the catheter inserted into the blood vessel. The bones make it difficult to see the marker.

  Therefore, conventionally, as shown in FIG. 6 (b), the examination and treatment are performed after changing the observation direction in a direction in which the overlap between the marker and the bone is avoided. By changing the observation direction in this way, it becomes easy to see the marker which has been difficult to see as shown in FIG. However, in recent years, various image processing techniques have been developed, and as shown in FIG. 7B, an object to be observed (for example, an organ or a therapeutic device) can be easily changed without changing the observation direction. You can see it.

JP 2003-284716 A

  However, as described above, with the development of image processing technology, examination and treatment can be performed without changing the observation direction even when the object to be observed overlaps with an organ that obstructs the observation of the object. Therefore, even if a better image quality can be obtained by changing the viewing direction, or if exposure is lower, it is not optimal in terms of image quality and exposure. Examination and treatment may continue with no observation direction.

  The present invention has been made to solve the above-described problems caused by the prior art, and can provide an operator with an appropriate observation direction in terms of image quality and exposure to improve image quality and reduce exposure. An object is to provide a radiographic apparatus.

In order to solve the above-described problems and achieve the object, the present invention irradiates a subject with X-rays, detects X-rays transmitted through the subject, and generates an X-ray fluoroscopic image based on the detected X-rays. An X-ray imaging apparatus to generate, a three-dimensional model generating means for generating a three-dimensional model representing a form of the subject and an arrangement of organs in the subject, and a tertiary generated by the three-dimensional model generating means In observing the object to be observed and the object based on the object position specifying means for specifying the position of the object to be observed in the original model, the position specified by the object position specifying means and the three-dimensional model An overlap determination unit that determines whether or not the organ to be inhibited overlaps in the observation direction, and the object to be observed and the organ to be obstructed by the overlap determination unit are If it is determined that going on, characterized by comprising the observation direction information output means for outputting the observation direction information indicating the other viewing direction in which the overlap is avoided, the.

According to the present invention, it is possible to improve the image quality and reduce the exposure by presenting the operator with an appropriate observation direction from the viewpoint of image quality and exposure.

  Exemplary embodiments of an X-ray imaging apparatus according to the present invention will be described below in detail with reference to the accompanying drawings. In the following embodiments, the case where the present invention is applied to an X-ray diagnostic apparatus will be described, and a catheter examination for treating a heart blood vessel using a catheter will be described as an example.

  First, the overall configuration of the X-ray diagnostic apparatus according to the present embodiment will be described. FIG. 1 is an external view showing the overall configuration of the X-ray diagnostic apparatus according to the present embodiment. As shown in the figure, this X-ray diagnostic apparatus is a C-arm that supports an X-ray irradiation unit that irradiates a subject with X-rays and an X-ray detection unit that detects X-rays transmitted through the subject in opposition to each other. And a holding device that supports the C arm, a couch device having a top plate on which the subject is placed, and an X-ray fluoroscopic image generated based on the X-rays detected by the X-ray detection unit are displayed. And a display portion.

  In such an X-ray diagnostic apparatus, when an X-ray angiography examination is performed, a subject is placed on the top plate of the bed apparatus, and a C-arm is placed around and around the body axis of the subject. By operating, examination and treatment are performed while observing blood vessels and therapeutic devices (for example, balloons and stents) from various directions.

  For this reason, depending on the direction of observation, a blood vessel, a therapeutic device, or the like to be observed may overlap with an organ (for example, a bone) that obstructs the observation. However, even in such a case, an object to be observed (for example, a blood vessel or a therapeutic device) can be easily observed by performing image processing on the X-ray fluoroscopic image. As a result, image deterioration and dose increase may occur.

  Therefore, in the X-ray diagnostic apparatus according to the present embodiment, an appropriate observation direction can be presented to the surgeon from the viewpoint of image quality and exposure so as to improve image quality and reduce exposure. Hereinafter, functions of the X-ray diagnostic apparatus will be specifically described.

  FIG. 2 is a block diagram illustrating a functional configuration of the X-ray diagnostic apparatus according to the present embodiment. As shown in the figure, this X-ray diagnostic apparatus includes an X-ray irradiation unit 1, an X-ray detection unit 2, a mechanism unit 3, a high voltage generation unit 4, a C arm 5, a top plate 6, A display unit 7, an operation unit 8, an image processing unit 9, and a system control unit 10 are included.

  The X-ray irradiation unit 1 is a device that irradiates a subject P to be examined (observation target) placed on the top plate 6 with X-rays, and uses a high voltage supplied from the high voltage generation unit 4. An X-ray tube that generates X-rays, and an X-ray diaphragm that controls an irradiation field by shielding a part of the X-rays generated by the X-ray tube.

  The X-ray detector 2 is an apparatus that generates X-ray image data by detecting X-rays that have passed through the subject P, and includes a flat detector that detects X-rays, a gate driver that extracts charges from the flat detector, and a gate It has a charge / voltage converter for converting the charge taken out by the driver into a voltage, and an A / D converter for converting the voltage converted by the charge / voltage converter into a digital value.

  The mechanism unit 3 is a device that moves the C-arm 5 and the top plate 6, and includes a C-arm rotation / movement mechanism that rotates and moves the C-arm 5, a top-plate movement mechanism that moves the top plate 6, and a system A mechanism control unit that controls the C-arm rotation / movement mechanism and the top plate movement mechanism based on an instruction from the control unit 10 is provided.

  The mechanism unit 3 uses the information indicating the amount of movement of the C arm 5 and the top plate 6 as positioning information, such as the state of the C arm 5 (position and rotation angle with respect to the top plate 6 and the position of the top plate 6). I remember it.

  The high voltage generation unit 4 is a device that supplies a high voltage necessary for the X-ray irradiation unit 1 to generate X-rays, and controls generation of the high voltage based on an instruction from the system control unit 10 to generate X-rays. An X-ray control unit that controls generation and a high-voltage generator that generates high voltage. The C arm 5 is an arm that holds the X-ray irradiation unit 1 and the X-ray detection unit 2, and the top plate 6 is a plate on which the subject P is placed.

  The display unit 7 is a device that displays an X-ray fluoroscopic image generated by the image processing unit 9 and includes a monitor that displays an image and a display control unit that controls display on the monitor. The operation unit 8 includes a mouse, a keyboard, a joystick, and the like, and is a console that receives an operation by an operator. The image processing unit 9 is a processing unit that generates an X-ray fluoroscopic image based on the X-ray image data generated by the X-ray detection unit 2.

  The system control unit 10 is a device that controls the entire X-ray diagnostic apparatus based on the operation of the operator. FIG. 3 is a block diagram illustrating a detailed functional configuration of the system control unit 10. As shown in the figure, the system control unit 10 includes a storage unit 11, a three-dimensional model generation unit 12, a marker position specifying unit 13, an overlap determination unit 14, as functional units particularly related to the present invention, An observation direction information output unit 15.

  The storage unit 11 is a storage unit that stores various data, programs, and the like, and stores an X-ray output condition 11a and standard form information 11b as information particularly relevant to the present invention. Here, the X-ray output condition 11a is information indicating the intensity of X-ray (the magnitude of X-ray dose) automatically controlled according to the body thickness of the subject during the examination. Each time the strength of is changed, it is updated to the latest state as needed.

  The standard form information 11b is information representing the standard form of the subject and the arrangement of organs in the subject. The standard form information 11b is, for example, information representing the arrangement and shape of organs in a standard human body. Note that the standard form information 11b is stored in the storage unit 11 in advance before the inspection.

  The three-dimensional model generation unit 12 is a processing unit that generates a three-dimensional model representing the form of the subject P and the arrangement of organs in the subject P. Specifically, the three-dimensional model generation unit 12 irradiates the subject P with information indicating the movement distance of the top 6 on which the subject P is placed, information indicating a characteristic part in the X-ray fluoroscopic image, and the like. A three-dimensional model is generated based on the information indicating the X-ray output conditions regarding the X-rays to be performed and the standard form information 11b indicating the standard form of the subject and the arrangement of organs in the subject.

  Here, the three-dimensional model generation unit 12 acquires information indicating the movement distance of the top plate 6 from the positioning information of the mechanism unit 3. The 3D model generation unit 12 acquires an X-ray fluoroscopic image from the image processing unit 9 for information indicating a characteristic site in the X-ray fluoroscopic image, and extracts a characteristic site from the acquired X-ray fluoroscopic image. Get by extracting. Further, the three-dimensional model generation unit 12 acquires the X-ray output condition 11a and the standard form information 11b from the storage unit 11. Then, the three-dimensional model generation unit 12 generates a three-dimensional model representing the form of the subject P and the arrangement of organs (for example, the heart and the spine) in the subject P based on the acquired information.

  For example, in a catheter examination, a catheter is inserted from the blood vessel of the subject P, and treatment is performed by advancing the distal end of the catheter to the heart while viewing an X-ray fluoroscopic image. At this time, the surgeon advances the catheter while moving the top plate 6 so that the distal end of the catheter is reflected in the X-ray fluoroscopic image displayed on the display unit 7. Therefore, for example, by measuring the distance that the top 6 has moved between the time when the catheter is inserted into the subject P and the time when the tip of the catheter reaches the heart, the location where the catheter is inserted (for example, the arm or leg) The distance from the root to the heart can be specified. By applying the partial distance specified in this way to the standard form information representing the form of the standard subject, the height of the subject P can be predicted.

  Further, in an examination performed under fluoroscopy such as a catheter examination, the intensity of the X-ray dose irradiated to the subject P is determined according to the body thickness of the subject. In order to obtain an X-ray fluoroscopic image of an image quality level necessary for the examination, it is necessary to irradiate a X-ray with a higher dose than usual for a subject having a large body thickness, and weaker than usual for a subject having a thin body thickness. This is because an X-ray fluoroscopic image having a required image quality level can be obtained even with a dose of X-rays. Therefore, for example, the body thickness of the subject P can be predicted by measuring the intensity of the X-ray dose irradiated to the subject P during the examination.

  The three-dimensional model generation unit 12 applies, for example, the height and body thickness of the subject P predicted as described above to the standard form information 11b acquired from the storage unit 11 to thereby determine the form of the subject P and the subject. A three-dimensional model representing the arrangement of organs in P is generated.

  The marker position specifying unit 13 is a processing unit that specifies the position of the object to be observed in the three-dimensional model generated by the three-dimensional model generating unit 12. For example, in a catheter examination, a blood vessel is treated by placing a treatment device such as a treatment balloon or a stent in the blood vessel, but it is attached to a guide wire as a mark when the treatment device is placed. A marker is used. This marker is usually formed of a small metal sphere or the like so as to stand out on the X-ray fluoroscopic image, and has a higher contrast when compared with surrounding organs on the X-ray fluoroscopic image. Therefore, in the present embodiment, the marker position specifying unit 13 specifies the position of the marker as the position of the object to be observed.

  Specifically, the marker position specifying unit 13 first specifies the position of the marker on the X-ray fluoroscopic image based on features such as the shape and size of the marker. Subsequently, the marker position specifying unit 13 specifies the position of the marker on the flat detector from the position of the marker specified on the X-ray fluoroscopic image. On the other hand, the marker position specifying unit 13 acquires positioning information from the mechanism unit 3, and based on the acquired positioning information, the state of the C arm 5 (position, rotation angle, etc. with respect to the top plate 6) and the top plate 6. The position of is detected.

  Thereafter, the marker position specifying unit 13 determines the position of the marker specified on the flat detector, the state of the detected position C arm 5 and the position of the top plate 6, and the plane fixedly determined in the X-ray diagnostic apparatus. Based on the positional relationship between the detector and the X-ray tube, a straight line in a three-dimensional space where a marker can exist is estimated. Then, the marker position specifying unit 13 specifies the position of the marker in the three-dimensional model from the estimated straight line and the position of the heart in the three-dimensional model generated by the three-dimensional model generation unit 12.

  When the treatment device is a stent, two markers indicating the positions of both ends of the stent are used. Therefore, the marker position specifying unit 13 may specify the position of the marker in the three-dimensional model by measuring the distance between the two markers. Alternatively, an image of the marker is taken at the start of the inspection, and the marker position specifying unit 13 compares the size of the marker in the image with the size of the marker in the fluoroscopic image captured during the inspection to enlarge the marker. The ratio may be calculated, and the position of the marker in the three-dimensional model may be specified based on the calculated enlargement ratio.

  The overlap determination unit 14 performs observation based on the position of the object to be observed (here, the position of the marker) specified by the marker position specifying unit 13 and the three-dimensional model generated by the three-dimensional model generation unit 12. It is a processing unit that determines whether or not a target object and an organ that becomes an obstacle to observing the object overlap in the observation direction. Here, a bone is taken as an example of an organ that becomes an obstacle to observing an object.

  Specifically, the overlap determining unit 14 acquires positioning information from the mechanism unit 3 when the marker position in the three-dimensional model is specified by the marker position specifying unit 13, and based on the acquired positioning information, The state of the C arm 5 and the position of the top plate 6 are detected. The overlap determining unit 14 is specified by the arrangement of organs in the three-dimensional model generated by the three-dimensional model generating unit 12, the detected state of the C arm 5 and the position of the top 6, and the marker position specifying unit 13. Based on the position of the marker, it is determined whether or not the marker and the bone overlap in the observation direction.

  Under X-ray fluoroscopy, how the X-rays appear in the subject P based on information such as the darkness level of the image in the fluoroscopy image, the fluctuations in the detected X-ray particles, the level of quantum noise, and the like. It can be estimated whether it has penetrated through various organs. Therefore, the overlap determination unit 14 may further determine whether or not there is a bone effect based on the difference in the image level / quantum noise level between the periphery of the marker and the entire image, the X-ray condition, and the like.

  The observation direction information output unit 15 displays observation direction information indicating another observation direction in which the overlap is avoided when the overlap determination unit 14 determines that the object to be observed and the obstructing organ overlap. It is a processing part to output.

  Specifically, the overlap determination unit 14 determines the information (three-dimensional) used by the overlap determination unit 14 when the overlap determination unit 14 determines that the object to be observed and the obstructing organ overlap. Marker based on the arrangement of organs in the three-dimensional model generated by the model generation unit 12, the state of the detected C-arm 5 and the position of the top plate 6, and the position of the marker specified by the marker position specifying unit 13) A new observation direction is derived that avoids the bones that obstruct the observation. Then, the overlap determination unit 14 outputs information indicating the derived new observation direction to the display unit 7 as observation direction information.

  FIG. 4 is a diagram illustrating an example of observation direction information output by the observation direction information output unit 15. For example, the observation direction information output unit 15 calculates the position and angle of the C arm 5 so that the subject P is irradiated with X-rays along the derived new observation direction, and the C arm is calculated to the calculated position and angle. Information indicating the operation direction for moving the image is output as observation direction information (see FIG. 5A).

  Thus, the observation direction information output unit 15 outputs information indicating the operation direction of the C-arm 5 to obtain a higher-quality X-ray fluoroscopic image for the operator or reduce exposure. Therefore, it is possible to easily recognize the operation direction of the C-arm 5 suitable for the purpose.

  Alternatively, the observation direction information output unit 15 observes the position of the object to be observed in the subject P (here, the position of the marker) and the object based on the derived new observation direction and the three-dimensional model. The information indicating the position of the organ (in this case, the position of the bone) and the derived X-ray irradiation direction, which is the new observation direction, is output as observation direction information (see (b) in the figure). ).

  Thus, the observation direction information output unit 15 indicates the position of the object to be observed, the position of the organ that is obstructed in observing the object, and the X-ray irradiation direction that can avoid the obstructed organ. By outputting the information, it is possible to make the operator easily recognize an observation direction suitable for obtaining an X-ray fluoroscopic image with higher image quality or reducing exposure.

  Furthermore, the observation direction information output unit 15 may output an X-ray fluoroscopic image before image processing is performed in addition to the above-described observation direction information (see FIG. 10C). Thus, by outputting an X-ray fluoroscopic image before image processing is performed, it is possible to make the operator effectively recognize that the current observation direction is not appropriate.

  In addition, the observation direction information output unit 15 outputs the observation direction described above only when the overlap determination unit 14 determines that the object to be observed and the obstructing organ overlap, thereby presenting the observation direction. Since necessary information is output only when necessary, provision of unnecessary information can be suppressed.

  Next, a processing procedure for viewing direction information display by the X-ray diagnostic apparatus according to the present embodiment will be described. FIG. 5 is a flowchart illustrating a processing procedure for viewing direction information display by the X-ray diagnostic apparatus according to the present embodiment. Here, a case where the position of the marker attached to the catheter is set as the position of the object to be observed will be described, and a bone will be described as an example of an organ that is obstructed when observing the marker.

  As shown in the figure, in the X-ray diagnostic apparatus according to the present embodiment, when the examination is started by the operator (Yes in step S101), the three-dimensional model generation unit 12 determines the form of the subject P and the subject. A three-dimensional model representing the arrangement of organs in P is generated (step S102).

  Subsequently, the marker position specifying unit 13 specifies the position of the marker in the three-dimensional model generated by the three-dimensional model generating unit 12 (step S103), and the overlap determining unit 14 is specified by the marker position specifying unit 13. Based on the position of the marker and the 3D model generated by the 3D model generation unit 12, it is determined whether or not the marker and the bone overlap (step S104).

  If the marker and the bone overlap each other (step S105, Yes), the observation direction information output unit 15 outputs observation direction information indicating another observation direction in which the overlap is avoided to the display unit 7. (Step S106).

  As described above, in this embodiment, first, the three-dimensional model generation unit 12 generates a three-dimensional model representing the form of the subject and the arrangement of organs in the subject. Thereafter, the marker position specifying unit 13 specifies the position of the marker in the 3D model generated by the 3D model generating unit 12 as the position of the object to be observed, and the overlap determining unit 14 is specified by the marker position specifying unit 13. Based on the position of the marker and the three-dimensional model generated by the three-dimensional model generation unit 12, it is determined whether or not the marker and an organ that becomes an obstacle to observing the marker overlap in the observation direction. To do. Then, when the observation direction information output unit 15 determines by the overlap determination unit 14 that the marker and the obstructing organ are overlapped, the observation direction information indicating another observation direction in which the overlap is avoided. Is output.

  Therefore, in the present embodiment, when an object to be observed and an organ that becomes an obstacle to observing the object overlap, an observation direction that can avoid the overlap is automatically presented. The surgeon can be urged to change the observation direction to a direction where the image quality can be further improved and a direction where the exposure can be further reduced. That is, in this embodiment, it is possible to improve the image quality and reduce the exposure by presenting the operator with an appropriate observation direction in terms of image quality and exposure.

  Further, in this embodiment, the three-dimensional model generation unit 12 causes the moving distance of the top plate on which the subject P is placed, a characteristic part in the X-ray fluoroscopic image, and X-rays related to X-rays irradiated to the subject. Since the 3D model is generated based on the output conditions and the standard morphological information representing the standard morphological form of the subject and the arrangement of organs in the subject, depending on the body type of the subject to be examined A three-dimensional model can be automatically generated.

  In this embodiment, the observation direction information output unit 15 indicates the operation direction of the C arm 5 that supports the X-ray irradiation unit 1 that irradiates X-rays and the X-ray detection unit 2 that detects the X-rays facing each other. Since the information to be displayed is output as observation direction information, the operator can easily recognize the operation direction of the C-arm 5 suitable for obtaining a high-quality X-ray fluoroscopic image or reducing exposure. be able to.

  In this embodiment, the observation direction information output unit 15 can avoid the position of the object to be observed in the subject P, the position of the organ that is obstructed when observing the object, and the organ that is obstructed. Since the information indicating the X-ray irradiation direction is output as observation direction information, it is easy for the operator to obtain an X-ray fluoroscopic image with higher image quality or to reduce the exposure. Can be recognized.

  In the present embodiment, the three-dimensional model generation unit 12 causes the moving distance of the top plate on which the subject P is placed, a characteristic part in the X-ray fluoroscopic image, and X-rays related to X-rays irradiated to the subject. A three-dimensional model is generated based on the output condition and standard morphological information representing the standard morphological form of the subject and the arrangement of organs in the subject.

  However, the method for generating the three-dimensional model is not limited to this. For example, three-dimensional image data related to the subject P obtained by another image diagnostic apparatus such as an X-ray CT (Computed Tomography) apparatus is further stored in the storage unit 11, and then the three-dimensional model generation unit stores the three-dimensional model data. A three-dimensional model may be generated based on the three-dimensional image data stored by the unit 11. This makes it possible to generate a three-dimensional model representing the form of the subject P and the arrangement of organs in the subject P more accurately, and to present a more accurate observation direction to the operator. It becomes possible.

  In addition, each component of each apparatus illustrated in the present embodiment is functionally conceptual and does not necessarily need to be physically configured as illustrated. In other words, the specific form of distribution / integration of each device is not limited to that shown in the figure, and all or a part thereof may be functionally or physically distributed or arbitrarily distributed in arbitrary units according to various loads or usage conditions. Can be integrated and configured.

  As described above, the X-ray imaging apparatus according to the present invention is useful in an X-ray angiography examination performed while observing a blood vessel and a therapeutic device from various directions under fluoroscopy. This is suitable when image quality improvement or exposure reduction is required.

It is an external view which shows the whole structure of the X-ray diagnostic apparatus which concerns on a present Example. It is a block diagram which shows the function structure of the X-ray diagnostic apparatus which concerns on a present Example. It is a block diagram which shows the detailed functional structure of a system control part. It is a figure which shows the example of the observation direction information output by an observation direction information output part. It is a flowchart which shows the process sequence of the observation direction information display by the X-ray diagnostic apparatus which concerns on a present Example. It is a figure which shows the change of the observation direction in the conventional X-ray imaging apparatus. It is a figure which shows the display of the image in the conventional X-ray imaging apparatus.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 X-ray irradiation part 2 X-ray detection part 3 Mechanism part 4 High voltage generation part 5 C arm 6 Top plate 7 Display part 8 Operation part 9 Image processing part 10 System control part 11 Memory | storage part 11a X-ray output condition 11b Standard form information 12 three-dimensional model generation unit 13 marker position specifying unit 14 overlap determination unit 15 observation direction information output unit

Claims (5)

An X-ray imaging apparatus that irradiates a subject with X-rays, detects X-rays transmitted through the subject, and generates an X-ray fluoroscopic image based on the detected X-rays,
Three-dimensional model generation means for generating a three-dimensional model representing the form of the subject and the arrangement of organs in the subject;
Position specifying means for specifying the position of the marker in the three-dimensional model generated by the three-dimensional model generating means;
Based on the position of the marker specified by the position specifying means and the arrangement of the organ in the three-dimensional model, the marker and a second organ of a different type from the first organ on which the marker is placed are X An overlap determination means for determining whether or not they overlap in the irradiation direction of the line;
When it is determined by the overlap determining means that the marker and the second organ overlap, based on the positional relationship between the position of the marker in the three-dimensional model and the second organ, Direction information output means for outputting direction information indicating the irradiation direction of other X-rays to avoid overlapping with the second organ to the display unit ;
An X-ray imaging apparatus comprising:   The three-dimensional model generation means includes information indicating a movement distance of the top plate on which the subject is placed, information indicating a characteristic part in the X-ray fluoroscopic image, and X related to X-rays irradiated on the subject. 2. The three-dimensional model is generated based on information indicating a line output condition, and standard form information representing a standard form of a subject and an arrangement of organs in the subject. X-ray imaging equipment. A three-dimensional image data storage unit for storing three-dimensional image data related to the subject obtained by another image diagnostic apparatus;
The X-ray imaging apparatus according to claim 1, wherein the three-dimensional model generation unit generates the three-dimensional model based on the three-dimensional image data stored in the three-dimensional image data storage unit. . The direction information output means, said display unit information indicating the operation direction of the support portion for supporting to face the X-ray detector for detecting X-ray irradiation unit and the X-ray irradiating the X-rays as the direction information X-ray imaging apparatus according to claim 1, 2 or 3, characterized in that output. The direction information output means displays, as the direction information, information indicating the position of the marker and the position of the second organ in the subject and the X-ray irradiation direction that can avoid the second organ. X-ray imaging apparatus according to any one of claims 1 to 4 and outputs the section.